Provider Demographics
NPI:1215912167
Name:KIDNEY & HYPERTENSION SPECIALISTS OF CENTRAL FLORIDA
Entity type:Organization
Organization Name:KIDNEY & HYPERTENSION SPECIALISTS OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADNAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-394-7027
Mailing Address - Street 1:PO BOX 120836
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34712-0836
Mailing Address - Country:US
Mailing Address - Phone:352-394-7027
Mailing Address - Fax:352-394-1361
Practice Address - Street 1:306 MOHAWK RD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34715-7434
Practice Address - Country:US
Practice Address - Phone:352-394-1361
Practice Address - Fax:352-394-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK2945Medicare PIN